Greece has made substantial progress in reforming its economy in a short period of time. A record fiscal consolidation by OECD standards has reduced the deficit, pension and health care reforms have enhanced longer-term fiscal sustainability, and structural reform has improved labour market flexibility and cost competitiveness. However, the adjustment programme agreed in 2010 between the Greek authorities, the International Monetary Fund, the European Commission and the European Central Bank has not yielded the expected results in restoring activity, which has been hit much harder than in other euro zone countries with adjustment programmes, such as Ireland, Portugal or Latvia (which has a euro peg). This has worsened the debt problem, despite the debt restructuring that took place in 2012, while unemployment has sharply increased. Restoring growth, making it sustainable and dealing with social costs are essential to the success of the adjustment programme.